Alternative medicine practitioners often derisively accuse skeptics and critics of being “reductionist.” This is intended to sound wise and knowing, but sneering at reductionism is a transparently convenient way to dismiss rational objections to crank theories and flaky bullshit — the main context in which it comes up. It insultingly insinuates a lack of vision and savvy about complex systems (like the body). It’s just an ideological gripe, not a meaningful thought, about people who allegedly can’t see the forest for the trees. This is quite ironic, coming as it usually does from barely-trained dabblers and dilettantes, people who clearly have not exactly mastered either forest or trees.
Anyone truly capable of seeing profound patterns in complex systems would be a scientific celebrity.
Certainly reductionism can go wrong, like nearly any mental mode.1 But reductionism isn’t an intellectual failing. The real thing — not the insult — is just one of many thinking and reasoning tools … not an all-consuming obliviousness to “the whole.”
It is not wrong to reduce human health to its constituents, and medical science should not be criticized for this. The nature of science is to slice a subject thinly, and this is a necessary and powerful way of trying to understand life (and almost anything else). Studying the bits and pieces of things has led pretty much directly to all kinds of medical marvels: vaccines and cancer treatments and every effective surgery ever devised are all about the triumph of understanding parts. Someday, we may well understand the whole by understanding its parts.
Or we may not!
Much of what is meant — or should be meant — by “holistic” medicine is that a person should be treated as though they are “more” than the sum of his or her biological parts, and cannot actually be understood only by understanding parts. This is certainly true in many ways, of course.
This “divide and conquer” strategy is responsible for almost every amazing accomplishment in the history of science, especially physics, chemistry, engineering, and medicine. So there is nothing fallacious about reductionist thinking, or dividing wholes into parts. However, this strategy may be less useful as applied to a complex system for several reasons.
Todd Hargrove, Playing With Movement: How to explore the many dimensions of physical health and performance, 2019, p. 57
But make no mistake: we also need to understand the parts! We do! Very much. Please, do not throw the reductionist baby out with the holistic bathwater.
If you think the world is too complicated for reductionism to be useful, then you don’t really know what reductionism is or how it works.
Dr. Christopher A. Moyer
For contrast: the fate of medicine without reductionism
You can’t very well study the parts of something if you can’t cut it up, can you? This is one major reason why traditional Chinese medicine (TCM) failed to keep pace with the efficacy of scientific medicine over the last century.
In contrast to the way science busily divides and isolates everything it studies, TCM was always correlations between health and vitality and a myriad of behavioural clues and superficial signs and symptoms. They had to do it this way: cultural and religious (Confucian) taboos made anatomical and physiological reduction difficult by making autopsy taboo.2
So the Chinese became awesome observers, and then went a step further and described what they learned rather poetically, for which I have always appreciated them. The language of TCM is richly, beautifully metaphorical, and its practice can take on a rather artistic flair. But to the critical Western ear, it all sounds rather absurd: what do you mean, I have too much “wood” in my liver?
This is the basis for some knee-jerk skeptical rejection of TCM. TCM has many problems, but it shouldn’t be dismissed just because it has a poetic character that sounds strange, of course. It’s not literal: TCM doesn’t claim you actually have wood in your guts. It’s poetic imagery for an elaborate system of describing patterns in human health.
Unfortunately, poetry just doesn’t get you that far in biology. Metaphor isn’t going to tell you Helicobacter pylori is what actually causes ulcers or that our immune systems mistake our own cell contents for invaders.3
TCM is probably the most ancient and sophisticated of all folk medicines — which isn’t saying much4 — but it remains very firmly in that category. While scientific medicine raced ahead, steadily explaining and solving one medical mystery and problem after another for about 150 years now — starting roughly with Pasteur and germ theory in the middle of the 19th Cenutry — TCM simply couldn’t compete. Its showcase treatment modality (acupuncture, of course) — has failed every serious test it has ever been put to, and modern Chinese medicine has largely abandoned it. It’s now a quaint relic of history, far less popular (in China and the rest of the world) than your neighbourhood acupuncturist would like us to believe.
About Paul Ingraham
I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of ScienceBasedMedicine.org for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter., or subscribe:
If you want to learn quite a lot more about reductionism, you could hardly do better than this lecture by Dr. Robert Sapolsky, what he called “one of the most difficult lectures” of the course it’s a part of.
And here's more reading about the role of science and critical thinking in medicine, for clinicians and patients:
- Confirmation Bias — Confirmation bias is the human habit of twisting our perceptions and thoughts to confirm what we want to believe
- How to Simplify Chronic Pain Puzzles — Use Occam’s razor to clean up a mess of theories about your stubborn injury or pain problem
- What’s a “Claim” in Health Care? — In health care, claims often involve a more self-serving assertion
- Science versus Experience in Musculoskeletal Medicine — The conflict between science and clinical experience and pragmatism in the management of aches, pains, and injuries
- Skepticism about skeptics from a skeptic, which touches on the topic of "scientism"
This article explores what's good and bad in both mainstream and alternative medicine:
- Alternative Medicine’s Choice: What should alternative medicine be the alternative to? The alternative to cold and impersonal medicine? Or the alternative to science and reason?
- See Dan Dennett’s concept of “greedy reductionism.”
- Fu L. Medical missionaries to China and the reformation of anatomy. Journal of Medical Biography. 2014 May. PubMed 24833543 ❐ I’ve seen the no-dissection-in-China claim made in many contexts, but disputed in others, and I have no way of readily resolving it. However, this paper makes it fairly clear that dissection probably was mostly avoided in China for centuries, whether it was impeded by a taboo or something else:
The earliest record of human anatomy in chapters of the Yellow Emperor's Inner Classic is likely to be based upon proper dissections. The first incident of human dissection for medical purpose documented in the History of Han Dynasty occurred in AD 13. During the Sung dynasty, a physician prepared illustrations of internal organs of executed criminals, published in 1113 as the Images of Truth. Successive Chinese medical treatises have plagiarized but preserved the anatomical diagrams without improvements or modifications. China had to wait till the mid-19th century for Anglo-American Protestant medical missionaries to bring about a complete and permanent reformation of anatomical science.However, it’s beside the main point: one way or another, medical reductionism was clearly not a feature of TCM.
- Ingraham. A Painful Biological Glitch that Causes Pointless Inflammation: How an evolutionary wrong turn led to a biological glitch that condemned the animal kingdom — you included — to much louder, longer pain. PainScience.com. 6608 words.
- ScienceBasedMedicine.org [Internet]. Ramey D. Acupuncture and history: The “ancient” therapy that’s been around for several decades; 2010 Oct 18 [cited 20 Sep 10]. PainSci Bibliography 54827 ❐
Saying that acupuncture is “not actually ancient” always upsets some folks. Sure, there are ancient antecedents for acupuncture — for practically anything — but acupuncture as we know it is largely a 20th Century invention.